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oai:repisalud.isciii.es:20.500.12105/74622024-11-28T19:24:18Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19609col_20.500.12105_16963

00925njm 22002777a 4500 dc Gonzalez-Sanz, Ruben author Casas-Alba, Didac author Launes, Cristian author Muñoz-Almagro, Carmen author Ruiz-García, Montserrat author Alonso, Mercedes author González-Abad, María José author Megías, Gregoria author Rabella, Nuria author Del Cuerpo, Margarita author Gozalo-Margüello, Mónica author González-Praetorius, Alejandro author Martínez-Sapiña, Ana author Goyanes-Galán, María José author Romero, María Pilar author Calvo, Cristina author Antón, Andrés author Imaz, Manuel author Aranzamendi, Maitane author Hernández-Rodríguez, Águeda author Moreno-Docón, Antonio author Rey-Cao, Sonia author Navascués, Ana author Otero, Almudena author Cabrerizo, Maria author 2019-02 IntroductionEnterovirus A71 (EV-A71) is an emerging pathogen that causes a wide range of disorders including severe neurological manifestations. In the past 20 years, this virus has been associated with large outbreaks of hand, foot and mouth disease with neurological complications in the Asia-Pacific region, while in Europe mainly sporadic cases have been reported. In spring 2016, however, an EV-A71 outbreak associated with severe neurological cases was reported in Catalonia and spread further to other Spanish regions.AimOur objective was to investigate the epidemiology and clinical characteristics of the outbreak.MethodsWe carried out a retrospective study which included 233 EV-A71-positive samples collected during 2016 from hospitalised patients. We analysed the clinical manifestations associated with EV-A71 infections and performed phylogenetic analyses of the 3'-VP1 and 3Dpol regions from all Spanish strains and a set of EV-A71 from other countries.ResultsMost EV-A71 infections were reported in children (mean age: 2.6 years) and the highest incidence was between May and July 2016 (83%). Most isolates (218/233) were classified as subgenogroup C1 and 217 of them were grouped in one cluster phylogenetically related to a new recombinant variant strain associated with severe neurological diseases in Germany and France in 2015 and 2016. Moreover, we found a clear association of EV-A71-C1 infection with severe neurological disorders, brainstem encephalitis being the most commonly reported.ConclusionAn emerging recombinant variant of EV-A71-C1 was responsible for the large outbreak in 2016 in Spain that was associated with many severe neurological cases. Euro Surveill. 2019 Feb;24(7). 10.2807/1560-7917.ES.2019.24.7.1800089 1560-7917 Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 30782267 http://hdl.handle.net/20.500.12105/7462 Encephalitis Enterovirus Epidemiology Outbreaks Surveillance Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016